Americans' concerns about Medicare's viability are very apparent. The Balanced Budget Act of 1997 reduced projected Medicare spending by $386 billion between 1998 and 2007, yet the Medicare Part A Trust Fund is still expected to be depleted by 2010. As a result, the current Medicare commission will be looking at ways to manage the costs of the program in the future. Tough choices will eventually have to be made by policymakers, who must answer to the voters. When asked to make choices, survey respondents opt to raise taxes rather than increase deductibles or go for a later eligibility age.

Americans Are Pessimistic About Medicare

  • Fifty-three percent of Americans are not confident that Medicare will continue to provide benefits of equal value to the benefits received by retirees today.
  • Americans younger than age 44 are the most pessimistic about Medicare's future. Among Americans between ages 35 and 44, 70 percent are not confident that Medicare will continue to provide benefits of equal value. Six in 10 between ages 20 and 34 indicate they are not confident (62 percent). Among Americans nearing retirement (ages 55 -64), 41 percent are not confident.
  • A majority of working Americans do not believe that the Medicare program will be able to provide them with health insurance throughout their retirement (56 percent). Among current retirees, 15 percent do not believe this will be the case.

Medicare Taxes v. Benefits: Americans Choose Higher Taxes

The 1998 HCS asked respondents to make tough choices assuming changes must be made to the Medicare program.

  • When asked to choose between higher payroll taxes for current workers or higher co-payments and deductibles for Medicare recipients, 54 percent of Americans favor increased payroll taxes; 40 percent favor increasing costs to Medicare recipients.
  • When asked to choose between raising the eligibility age from 65 to 67 or increasing payroll taxes, 50 percent of Americans prefer increased taxes; 46 percent prefer raising the eligibility age.

Interestingly, there is little variation in preferences for changing Medicare across generations. However, workers and retirees responded very differently.

  • Workers are more likely to prefer increasing payroll taxes over a change in the eligibility age. While 53 percent of workers prefer an increase in payroll taxes, only 39 percent of retirees prefer that option.
  • When asked to choose between increasing co-payments and deductibles for current Medicare recipients and increasing the Medicare eligibility age to 67, workers are more likely than retirees to prefer increasing co-payments and deductibles (50 percent of workers favor v. 40 percent of retirees).

Later Middle Age Generates Concerns About Health Care and Medicare

The 1998 HCS asked respondents how confident they are about certain aspects of health care during the next 10 years, and asked those under age 65 how confident they will be about those same aspects of care under Medicare.

  • Overall, Americans under age 65 are more confident about their health care over the next 10 years than they are in the care they will receive under Medicare. Between one-fifth and one-third of Americans younger than age 65 are confident in aspects of their health care over the next 10 years. However, when considering the same aspects of health care under Medicare, no more than one-fifth indicate high levels of confidence.
  Percentage Extremely or Very Confident
Aspect of Care For Next 10 Years Under Medicare
Able to get the treatments you need 33% 18%
Access to quality health care 33 19
Enough freedom to choose who provides your medical care 26 15
Able to afford health care without suffering financial hardship 21 13

Source: 1998 Health Confidence Survey.